Kuntscher first described the technique of im nailing femur fractures in the german and later in the american. The compliance of the nail construct was adjusted by overdrilling the near cortex reliable fracture union since the surgeon can. T2 tibia spi offers two size options of drill sleeve available to accommodate nail diameters 8mm. Trigen meta nail tibial nail specifications driving end of nail all knee and distal tibial top view of nail nondriving end of nail ml view ap view set does not include all sizes. Use of intramedullary nail in distal metaphyseal fractures. With a shape engineered to optimally fit all patient anatomies, the oic tibial nail has been designed with value and predictable outcomes in mind its value that reaches all of us. Please keep in mind that variations in magnification do occur. Fatigue strength of common tibial intramedullary nail. A more distal entry point may result in damage to the posterior cortex during nail insertion. The center point of the portal is located slightly medial to the lateral tibial spine as visualized on the ap radiograph and immediately adjacent and anterior.
Twentynine patients were included from our hospital. Fixation with intramedullary nail has frequently been used and proven to be efficient in displaced tibial shaft fractures 18. Distal locking screws for intramedullary nailing of tibial. However, pain in the knee joint is the most common. These views are not to scale and should be used as a pictorial representation only. The titanium tibial nail system the royal childrens. Tibial fractures are the most common long bone injury. Stryker has created a next generation locking nail system, bringing together all the capabilities and benefits of separate nailing systems to create a. Trigen humeral nail surgical technique pdf writer telegraph. Generally, a nail diameter 1 mm less than the final reamer diameter is chosen. Trigen knee nail and distal tibial nail specifications driving end of nail all knee nails and distal tibia nondriving end of nail ml view the distal tibial nail is on limited release, in the us market. Russell, md, mba university of mississippi medical center treatment goals shaft fracture. We report a case of inadvertent penetration of the tibiotalar joint by the smooth guide wire caused by incarceration of a fracture fragment between the nail and.
Intramedullary nailing of proximal third tibial fractures. Kalamazoo, mi and trigen smith and nephew, memphis, tn nails with the. The nails may be either solid or cannulated hollow. A comparison of the relative costs of cast treatment and.
When selecting the appropriate nail size take all aspects of the fracture into consideration. Pdf complications associated with the metanail tibial. Extending the indications of intramedullary nailing with. The nails have been designed for specific applications to help restore the shape of the fractured bone to its natural, preinjured state. The studies selected were original articles that fulfilled the following criteria. Enhanced fixation via threaded screw holes and polyethylene bushings offer better solutions for the fixation of complex fractures. In our study, we first fixed the fibula and then the tibial fracture, which facilitated alignment of the tibial fracture and nail insertion. Titanium cannulated tibial nail expert nailing system surgical technique depuy synthes trauma 5 indications the tibial nailex is intended to stabilize fractures of the proximal and distal tibia and the tibial shaft, open and closed tibial shaft fractures, certain pre. Distal end of nail all knee and distal tibial top view of nail nondriving end of nail ap view ml view set does not include all sizes. Get tibial nail at best price with product specifications. Pdf complications associated with the metanail tibial nail end. The trigen metanail tibial nail is indicated for fractures of the proximal and distal third of the tibia, including the shaft, stable and unstable fractures, non. The trigen metanail tibial nail is the latest addition to the trigen family of intramedullary nails.
We experienced three cases of refracture and two cases of failure to remove the nail while trying to take out ace tibial nails from healed tibial fractures. Tibial nails have locking screw holes close to both ends, in multiple orientations, for better fixation of proximal and distal fractures. Fatigue strength of common tibial intramedullary nail distal locking screws article pdf available in journal of orthopaedic surgery and research 41. Trigen metanail tibial nail specifications driving end of nail all knee and distal tibial top view of nail nondriving end of nail ml view ap view set does not include all sizes. This revolutionary system is radiation free, position independent, and provides 3d real time feedback of location and orientation of the drill relative to. Trigen meta nail tibial nail specifications distal end of nail all knee and distal tibial top view of nail nondriving end of nail ap view ml view set does not include all sizes. Intramedullary nailing system has become increasingly popular as a treatment option for long bone fractures, it is suitable for all fractures extending from 78 cm distal to the tibial plateau, to within 5. Complications associated with the metanail tibial nail. For the cannulated ctn, place the nail over the guide rod and into the tibial opening with the insertion handle oriented anteriorly. Mean item and total costs for each group mean number of items cost item plaster group nail group n 18 n 21 a ft e processing 1 1 clerking 1 1 operation hours 0.
All intertan nail templates are available with 117% magnification to compensate for radiographic magnification. The t2 tibial nailing system represents strykers latest and most comprehensive development of the original intramedullary principles presented by prof. Pdf the indications for intramedullary nailing have expanded to include most tibial shaft. Wchcoated fixation kwires designed for secure fixation in tibial plateau to prevent anteriorization and back out of sleeves during reaming. Ao principles 4 synthes titanium cannulated tibial nail expert system technique guide 1. Phoenix tibial nail system featuring corelocktm technology. Evaluation of trigen sureshot distal targeting system a new. Tibial nailing is related with relatively low incidence of nonunion, malunion, infection and compartmental syndrome 911. While there are no reported longterm clinical outcomes of this technique, cadaveric investigations have shown it to be a safe technique. Rehabilitation following bilateral tibial intramedullary. Dental assisting training video for dental office staff. Rehabilitation following bilateral tibial intramedullary nail placement in an elite athlete sharon young abney, spt. More recent developments in the evolution of the tibial nail include the addition of a. Pdf fatigue strength of common tibial intramedullary.
With a full range of sizes, the tibial nail is a comprehensive approach to the treatment of tibial fractures. Trigen metanail instrumentation bmt medical devices. A medullary canal obliterated by a previous fracture or tumor. It is composed of a titanium alloy and is available in 4 diameters 8. The trigen meta nail tibial nail is the latest addition to the trigen family of intramedullary nails. The trigen metanail tibial nail system is designed specifically to repair fractures of the proximal and distal thirds of the tibia, including the shaft, stable and. Trigen meta nail retrograde femoral nail technique. Trigen meta nail tibial nail specifications driving end of nail all knee and distal tibial top view of nail ml view nondriving end of nail ap view does not include all sizes. Intramedullary nailing of the tibia with suprapatellar entry and semiextended. Various methods of managing tibial fractures have been described in the literature over the years, ranging from plaster, functional bracing, compression plating external fixation and intramedullary im nailing 18. This system is ionizing radiation free, position independent, and provides 3d real time feedback of location and orientation of the drill relative to the. For nail sizes 12 and mm, the proximal nail diameter matches the shaft diameter. Immediate versus delayed intramedullary nailing for open.
Solid nails may protect somewhat against infection because they have no internal dead space. Reduced flexion leads to less pull from the quadriceps mechanism, helping to avoid fracture malreductions and misalignment the semiextended technique offers reductions, imaging and less angulation of the proximal segment while offering the enhanced. Indications include transverse, comminuted, spiral, oblique. Nailing in extension for trigen metanail tibial nails. Surgical technique international version medical ortovit. Inadvertent complications during this stage have been reported. In order to determine the risk factors associated with difficulties in nail removal, these five patients were compared in the parameters of age, gender, duration of nail in situ, nail diameter, nail length, and level of fracture with 30. The zimmer natural nail system is a system of intramedullary nails, screws, instruments and other associated implants that are designed to provide stable internal fixation for fractured long bones. Difficulties in removing ace tibial intramedullary nail.
The titanium tibial nail system surgical technique 16 inserting the nail for the solid utn, place the nail into the tibial opening with the insertion handle oriented anteriorly. Unusual complication following intramedullary nailing of. In the international markets, the distal tibial nail is sold in select countries. When treating distal tibia fractures with a tibial nail, stresses are. Download fulltext pdf complications associated with the metanail tibial nail end cap article pdf available in injury extra 44s 1012. Universal tibial nail ii universal tibial nail ii position the patient supine on the radiolucent table. Tibial bone transport over an intramedullary nail using cable and pulleys duration. Verify and confirm location under biplanar fluoroscopic guidance. Insertion of the nail requires threading of the nail over a smooth guidewire. Elastic nail insertion sleeves designed to serve as working channel to protect joint space. This bone model has been previously used for several biomechanical studies. Tibial shaft fracture is considered the most common long bone in orthopaedic practice.
The trigen knee nail is indicated for shaft fractures between the proximal and distal third of the tibia. Deborah michael wendland, pt, dpt, phd, cped mercer university atlanta, ga abstract background. Length alignment rotation mobile joint mobile joint wb extremity when to nail gold standard for tibial shaft fractures possible in proximal and distal tibial fractures with appropriate technique. Complications associated with the metanail tibial nail end cap. The phoenix tibial nail system is composed of titanium alloy and features corelock technology that offers a preassembled, embedded locking mechanism for locking all proximal oblique screws, which can also be used to internally mechanically compress up. Static and dynamic locking options provide for a range of options to help treat a broad spectrum of fracture patterns. They also reported that the overall chronic infection rate was 4%, with no infections in type i, ii, and iiia open fractures and a % rate in type iiib open fractures.
For nail sizes 811 mm, the proximal diameter is 11. In 1958, the ao formulated four basic principles, which. In 20042005 our hospital took part in the multicenter clinical trial. Tibial intramedullary nail 3d cad model library grabcad. Enhanced fixation via threaded screw holes and polyethylene bushings offer excellent solutions for the fixation of complex fractures. Trigen metanail tibial nail specifications driving end of nail all knee and distal tibial top view of nail ml view nondriving end of nail ap view does not include all sizes. The trigen sureshot distal targeting system utilizes an electromagnetic field generator, a probe inserted into the nail, and virtual imaging to facilitate distal locking without fluoroscopy. Utilizing the same trigen instruments, the tan was developed to simplify the surgical approach by allowing placement of the nail through the greater trochanter instead of the piriformis fossa. Download download trigen humeral nail surgical technique pdf writer read online read online trigen humeral nail surgical technique pdf writer official fulltext paper pdf. A comparative study evaluating plate and nail fixation by egol et al. Semiextended intramedullary nailing of the tibia using. Efficacy study of surgical technique in intramedullary. The trigen semiextended instrumentation facilitates intramedullary nailing procedures of the tibia with less flexion of the knee joint. Intramedullary nailing is a standard form of treatment for diaphyseal tibial fractures.
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